Private consultant can't or won't prescribe?

[3phase]

I saw a private consultant at a Nuffield hospital last week for an ongoing problem. He recommended a new drug regimen and said he couldn't prescribe but would write to my GP instructing them to do so and would send me a copy of his letter. My copy arrived yesterday so I called the GP to ask about collecting the prescription. The receptionist confirmed they'd had the letter but said the GP probably wouldn't have time to review it this week so to call again next week. I'm in quite a bit of pain and anxious to start the new drugs. They're not 'controlled' I shouldn't imagine - they're not painkillers or anything - it's a kidney problem. Is this normal protocol here? Can private consultants only prescribe via the GP? We've just moved from the Channel Islands to the UK. My consultant always issued prescriptions himself there but maybe things are different here? Thank you.

DD used to get private prescriptions from a private consultant that we had to pay the actual price for. NHS consultant gave us a letter to take to the GP to get NHS prescriptions. That would be turned round in the same time as a repeat prescription - two days.

I saw the consultant a week ago today.

Just a bit that a consultant I'm paying for has to prescribe via an NHS GP? Wondered if it was Nuffield policy or something... Thanks anyway. Patience is a virtue and all of that I guess

Honestly, you will be grateful that they are being sent to your GP. The cost of drugs via a private Px is eye watering.

I expect it was a cost issue. Way cheaper (for you) via a GP

Private consultants can prescribe

DH is a consultant - private and NHS. Private consultant can certainly prescribe.

The consultant may have been trying to help if the private prescription cost is higher than the equivalent cost of a NHS prescription. Are you sure he said he "can't" prescribe?

Yeah, he definitely said "can't". I'm going to call his secretary now and ask. I'm happy to pay (the pain is eye watering too)!

Spoke to his secretary. She said he always prescribes via GP but wasn't impressed that the surgery still hadn't issued the Px. She suggested making an actual apt with a GP and taking my copy of the letter which I'm about to do. Thanks all.

It makes no sense that your consultant can't prescribe- you ought to ask why and be given an explanation.

it's usually the other way round!

Often consultants can prescribe drugs that 'mere' GPs can't.

There is also the issue of a GP 'obeying' a consultant - some will but some won't. In the past consultants could dictate what drugs GPs prescribed, but there are some drugs that are prescribed 'off licence' and only from a consultant, who is willing to take personal responsibility for them.

I've had drugs prescribed by a consultant for several years. They are slightly more £££ than the NHS prescription but not excessively so.

Your consultant ought to have given you a script to be going on with and then asked your GP to issue repeats as needed.

I saw a private consultant recently and she said I would have to pay for the drugs she prescribed but some GPs were willing to write up the drugs so that I could get them on the NHS. She suggested I ask my GP which I did and she is willing so the consultant will send her the details of the prescription. I think it's at the discretion of the GP to be honest.

IIRC, some drugs can only be prescribed via an NHS contract?

The GP was quite annoyed when I saw him. He said the reason the consultants don't prescribe is because they like shunting their workload onto the GP's! He then got more irate when he realised one of the drugs that I was being prescribed required regular blood tests and the consultant hadn't made any arrangements for this / told me about it / taken responsibility for it.

Anyway, I've had the blood tests and the prescription now, both via the NHS. Felt rather bad for the GP at the end of it all. It does seem a bit cheeky. I'm going to mention it when I next see the consultant. I also think that given that I started off by going to a private consultant, it's quite reasonable to expect me to pay for any resulting prescriptions / investigations that resulted from that appointment. Actually I did expect that and was perfectly prepared for it.

I sympathise with your GP and actually would have (depending on the drug) refused to prescribe and bounced it back to the private GP. The ones that require monitoring should be prescribed by a strict protocol and these are usually agreed at local level on grounds of SAFETY. The person who signs the prescription has ultimate responsibility for it and needs to ensure you have been fully counselled about the drug and its side effects. This usually happens with dangerous meds like methotrexate. Also the shared care protocols have guidelines of who to contact if bloods go outside the normal range. Where I am who have to checks hat the patient has had monitoring bloods done every time we prescribe and if the bloods are abnormal we have to contact the patient to stop, email the advice line for help and then review patient. It is a LOT of work. But no, we GPs are sitting twiddling our thumbs and can "just sign a script"
If your drugs need monitoring who is your GP having to speak to for advice?
Drug safety is a huge part of prescribing and rushing it is how mistakes are made.
I do feel sorry for the patients lime you OP WHO ARE piggy in the middle.

*like not lime and sorry for the capitals

My private consultant (at a Nuffield Hospital) writes out private prescriptions for some of my drugs. I then take it to our NHS surgery and have it "converted" into an NHS prescription (usually have to allow 48 hours). If I took the private prescription direct to a pharmacy I would have to pay the full cost of the drug.

I really think that's taking the p....OP!

I get a repeat prescription every 3-4 months from my consultant and his office deals with them at no cost. I pay for the items on a private prescription and it's roughly £10 a month on average so not hugely different to NHS.

Trying to save himself work this way is really not on imo.

I was once refused a drug by my then GP - which another consultant suggested I could have- because the GP would have been liable etc for any side effects - and they were unwilling to do this as the drug was 'off licence' in the UK. It was too costly to buy privately so I didn't get it in the end.

It seems like an insanely unfair system for the NHS / GPs I agree. I'm not even sure who I'm supposed to contact if I have a problem with any of the drugs now. I'm uncertain if I'm technically under the care of private consultant or the GP...

We live quite rurally and I reckon this is part of the problem. When I had CT scans I had to be referred back to the NHS to have them because they couldn't be done at the Nuffield and then get re-referred to the private consultant for the results. He only does one afternoon a fortnight at the Nuffield and at some point my address was uploaded wrongly onto the NHS system so I missed the first apt for the scans and then once I'd had the second apt, I had to wait almost 3 weeks to see him for the results. The whole process took ages. And now this with the prescriptions.

I think I'm going to ask the consultant to either see me as an NHS patient here or refer me to a private consultant at a private hospital in London. Being between the two doesn't appear to work very well!

I think the consultant sounds a bit useless TBH.

Is there anyone else you can see?

He is doing you a massive favour. Some drugs cost hundreds privately and the insurance won't cover it. I'm lucky I have an understanding GP who writes the scripts I need. Silly to say it's cheeky as you're still saving the nhs all that clinic time. I'd switch GP rather than consultant if he persists in being difficult. He's not trying to save himself work - I expect it's really expensive. Just because some drugs are cheap privately doesn't mean they all are!